羟考酮联合帕瑞昔布钠在腹腔镜胆囊切除术后自控静脉镇痛中的应用

发布时间：2018-01-17 23:31

本文关键词：羟考酮联合帕瑞昔布钠在腹腔镜胆囊切除术后自控静脉镇痛中的应用　出处：《山东医药》2017年10期 　论文类型：期刊论文

【摘要】：目的观察腹腔镜胆囊切除术后应用羟考酮联合帕瑞昔布钠自控静脉镇痛的效果及其对患者免疫功能的影响。方法将118例行腹腔镜胆囊切除术患者随机分为A组和B组各59例,术后均采用自控静脉镇痛;其中A组镇痛泵配方为吗啡联合帕瑞昔布钠,B组为羟考酮联合帕瑞昔布钠。于术后3、12、24、48 h,分别采用视觉模拟评分(VAS)、Ramsay镇静评分法评价两组疼痛、镇静程度,统计两组不良反应发生率;分别于麻醉前(T_0)、术毕(T_1)及术后12 h(T_2)、第1天(T_3)、第3天(T_4)取静脉血,检测两组细胞免疫功能指标。结果两组术后不同时点VAS、Ramsay镇静评分及药物不良反应发生率比较,P均0.05;两组术后T_1、T_2、T_3时各细胞免疫功能指标较T_0时下降(P均0.05),A组低于B组(P均0.05)。结论腹腔镜胆囊切除术中采用羟考酮联合帕瑞昔布钠自控静脉镇痛可起到较好的镇痛、镇静效果,同时还可减轻对患者细胞免疫功能的抑制。
[Abstract]:Objective to observe the effect of intravenous analgesia with hydroxycodone combined with paroxib sodium for patient-controlled intravenous analgesia after laparoscopic cholecystectomy. Methods 118 patients undergoing laparoscopic cholecystectomy were randomly divided into A. There were 59 cases in group B and 59 cases in group B. Postoperative patient-controlled intravenous analgesia was used. The analgesic pump formula of group A was morphine combined with paroxib sodium. Group B was treated with hydroxycodone and paroxib sodium. Visual analogue score was used for 48 hours after operation. The Ramsay sedation score was used to evaluate the pain and sedation degree of the two groups, and the incidence of adverse reactions in the two groups was counted. Venous blood was collected on the first day before anesthesia, at the end of the operation, and at 12 hours after operation. Results the scores of VAS-Ramsay sedation and the incidence of adverse drug reactions were 0.05 at different time points after operation in the two groups. In both groups, the indexes of cellular immune function in T _ 1 / T _ 2 and T _ 3 were lower than those in T _ (0) (P < 0.05). Conclusion Hydrocodone combined with paroxib sodium for patient-controlled intravenous analgesia in laparoscopic cholecystectomy can play a good analgesic and sedative effect. At the same time, it can reduce the inhibition of cellular immune function of patients.
【作者单位】：成都市第三人民医院;
【分类号】：R614.4
【正文快照】： 随着我国人民生活水平及对于手术质量要求的逐渐提高,腹腔镜手术被广泛应用于临床[1]。近年来,尽管微创手术及麻醉技术的广泛应用,使广大患者疼痛得到明显减轻,但手术依然是一种创伤性操作,不可避免地会给患者带来一定创伤而致其术后疼痛。腹腔镜胆囊切除术后疼痛可致患者产生

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